Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation

Abstract Post-catheter-ablation left atrial volume index (LAVI) and left atrial reverse remodeling (LARR) predict successful sinus rhythm maintenance in patients with atrial fibrillation (AF). Although the prognostic value of LAVI has been established in prior literature, few have directly compared...

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Main Authors: Hironori Ishiguchi, Yasuhiro Yoshiga, Masakazu Fukuda, Shohei Fuji, Masahiro Hisaoka, Shintaro Hashimoto, Takuya Omuro, Noriko Fukue, Shigeki Kobayashi, Motoaki Sano
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13311-w
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author Hironori Ishiguchi
Yasuhiro Yoshiga
Masakazu Fukuda
Shohei Fuji
Masahiro Hisaoka
Shintaro Hashimoto
Takuya Omuro
Noriko Fukue
Shigeki Kobayashi
Motoaki Sano
author_facet Hironori Ishiguchi
Yasuhiro Yoshiga
Masakazu Fukuda
Shohei Fuji
Masahiro Hisaoka
Shintaro Hashimoto
Takuya Omuro
Noriko Fukue
Shigeki Kobayashi
Motoaki Sano
author_sort Hironori Ishiguchi
collection DOAJ
description Abstract Post-catheter-ablation left atrial volume index (LAVI) and left atrial reverse remodeling (LARR) predict successful sinus rhythm maintenance in patients with atrial fibrillation (AF). Although the prognostic value of LAVI has been established in prior literature, few have directly compared the clinical significance of LAVI and LARR. This study compared the significance of the post-ablation LAVI and LARR for clinical events after catheter ablation in patients (n = 365; age 66 ± 9 years; men, 77%) with persistent AF who underwent their first catheter ablation. We calculated the LARR magnitude using the pre- and post-ablation LAVI. Post-ablation LAVI and LARR were divided into tertiles and compared the incidence of major adverse cardiovascular events (MACE: all-cause death, unplanned heart failure hospitalization, and cardiovascular hospitalization) across tertiles. Over a median follow-up of 5.2 (interquartile range 3.1–7.0) years, 57 (16%) patients experienced at least one event. MACE incidence significantly increased across ascending post-ablation LAVI tertiles (cumulative incidence [95% confidence interval]: 1st [:<38 mL/m2], 8.4% [2.9–13.5] vs. 2nd [38–52 mL/m2], 11.6% [5.4–17.5] vs. 3rd [> 52 mL/m2], 21.7% [12.4–30.0], p < 0.001). However, MACE incidence was comparable across LARR tertiles (p = 0.900). Multivariate analysis identified post-ablation LAVI as an independent factor associated with post-ablation MACEs but not with post-ablation LARR. To conclude, the incidence of MACE increased significantly with the increase in post-ablation LAVI, but not with post-ablation LARR.
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spelling doaj-art-1ced9436deaa4cc89071f2bfd7f8bc7a2025-08-20T04:02:56ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-13311-wComparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillationHironori Ishiguchi0Yasuhiro Yoshiga1Masakazu Fukuda2Shohei Fuji3Masahiro Hisaoka4Shintaro Hashimoto5Takuya Omuro6Noriko Fukue7Shigeki Kobayashi8Motoaki Sano9Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineDepartment of Medicine and Clinical Science, Faculty of Health Sciences, Yamaguchi University Graduate School of MedicineYamaguchi University Wellness Science CenterDepartment of Therapeutic Science for Heart Failure in the Elderly, Yamaguchi University School of MedicineDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineAbstract Post-catheter-ablation left atrial volume index (LAVI) and left atrial reverse remodeling (LARR) predict successful sinus rhythm maintenance in patients with atrial fibrillation (AF). Although the prognostic value of LAVI has been established in prior literature, few have directly compared the clinical significance of LAVI and LARR. This study compared the significance of the post-ablation LAVI and LARR for clinical events after catheter ablation in patients (n = 365; age 66 ± 9 years; men, 77%) with persistent AF who underwent their first catheter ablation. We calculated the LARR magnitude using the pre- and post-ablation LAVI. Post-ablation LAVI and LARR were divided into tertiles and compared the incidence of major adverse cardiovascular events (MACE: all-cause death, unplanned heart failure hospitalization, and cardiovascular hospitalization) across tertiles. Over a median follow-up of 5.2 (interquartile range 3.1–7.0) years, 57 (16%) patients experienced at least one event. MACE incidence significantly increased across ascending post-ablation LAVI tertiles (cumulative incidence [95% confidence interval]: 1st [:<38 mL/m2], 8.4% [2.9–13.5] vs. 2nd [38–52 mL/m2], 11.6% [5.4–17.5] vs. 3rd [> 52 mL/m2], 21.7% [12.4–30.0], p < 0.001). However, MACE incidence was comparable across LARR tertiles (p = 0.900). Multivariate analysis identified post-ablation LAVI as an independent factor associated with post-ablation MACEs but not with post-ablation LARR. To conclude, the incidence of MACE increased significantly with the increase in post-ablation LAVI, but not with post-ablation LARR.https://doi.org/10.1038/s41598-025-13311-wAtrial fibrillationHeart failureCatheter ablationReverse remodelingMajor adverse cardiovascular events
spellingShingle Hironori Ishiguchi
Yasuhiro Yoshiga
Masakazu Fukuda
Shohei Fuji
Masahiro Hisaoka
Shintaro Hashimoto
Takuya Omuro
Noriko Fukue
Shigeki Kobayashi
Motoaki Sano
Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation
Scientific Reports
Atrial fibrillation
Heart failure
Catheter ablation
Reverse remodeling
Major adverse cardiovascular events
title Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation
title_full Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation
title_fullStr Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation
title_full_unstemmed Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation
title_short Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation
title_sort comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation
topic Atrial fibrillation
Heart failure
Catheter ablation
Reverse remodeling
Major adverse cardiovascular events
url https://doi.org/10.1038/s41598-025-13311-w
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